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Fridlund, Bengt
Publications (10 of 109) Show all publications
Valaker, I., Fridlund, B., Wentzel-Larsen, T., Hadjistavropoulos, H., Nordrehaug, J. E., Rotevatn, S., . . . Norekval, T. M. (2019). Adaptation and psychometric properties of the Norwegian version of the heart continuity of care questionnaire (HCCQ). BMC Medical Research Methodology, 19, 1-15, Article ID 62.
Open this publication in new window or tab >>Adaptation and psychometric properties of the Norwegian version of the heart continuity of care questionnaire (HCCQ)
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2019 (English)In: BMC Medical Research Methodology, ISSN 1471-2288, E-ISSN 1471-2288, Vol. 19, p. 1-15, article id 62Article in journal (Refereed) Published
Abstract [en]

Background: Continuity of cardiac care after hospital discharge is a priority, especially as healthcare systems become increasingly complex and fragmented. There are few available instruments to measure continuity of cardiac care, especially from the patient perspective. The aim of this study was (1) to translate and adapt the Heart Continuity of Care Questionnaire (HCCQ) to conditions in Norway, and (2) to determine its psychometric properties in self-report format administered to patients after percutaneous coronary intervention (PCI). Methods: The HCCQ was first translated into Norwegian from the original English version, following a widely used cross-cultural adaptation process. Data were collected before hospital discharge and in a follow-up after 2months. To assess psychometric properties, a confirmatory factor analysis (CFA) was performed and three aspects of construct validity were evaluated: structural validity, hypotheses testing and cross-cultural validation. Internal consistency of the HCCQ subscales was calculated using Cronbach's alpha, while intra-class correlation (ICC) was used to assess test-retest reliability. Additionally, socio-demographic and patient-reported data were collected to correlate with HCCQ scores. Results: Of those included at baseline, 436 (76%) completed the questionnaires after 2months. CFA suggested that the fit of the HCCQ data to a 3-factor model was modest (RMSEA = 0.11, CFI = 0.90, TLI = 0.90). However, convergent validity was satisfactory, based on existing research. Internal consistency was good, as indicated by its Cronbach's alphas: total continuity of care (0.95); informational (0.93), relational (0.87), and management (0.89) continuity. The ICC for the total HCCQ score was 0.80 (95% CI [0.71, 0.87] p<0.001). As indicated by negative care experiences (rated as 1 or 2 on the five-point scale), patients seemed to have limited knowledge about medical treatment, lifestyle modification and follow-up after PCI. Participation in cardiac rehabilitation and longer consultations with the general practitioner after hospital discharge were positively correlated with better continuity of care. Conclusions: Implementation of the HCCQ will likely support healthcare providers and researchers in identifying problem areas of continuity of cardiac care and in evaluating interventions aimed at improving continuity of care.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Cardiac care, Confirmatory factor analysis, Continuity of care, Cross-cultural adaptation, Patient perspective, Percutaneous coronary intervention, Psychometric properties, Validation
National Category
Cardiac and Cardiovascular Systems Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-81697 (URN)10.1186/s12874-019-0706-z (DOI)000461903000002 ()30885143 (PubMedID)2-s2.0-85063156858 (Scopus ID)
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-11-08Bibliographically approved
Björklund, M., Fridlund, B. & Mårtensson, J. (2019). Experiences of psychological flow as described by people diagnosed with and treated for head and neck cancer. European Journal of Oncology Nursing, 43, 1-8, Article ID 101671.
Open this publication in new window or tab >>Experiences of psychological flow as described by people diagnosed with and treated for head and neck cancer
2019 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 43, p. 1-8, article id 101671Article in journal (Refereed) Published
Abstract [en]

Purpose: To describe flow as experienced by people diagnosed with and treated for head and neck cancer. Method: A descriptive design based on a deductive qualitative content analysis was used to explain Csikszentmihalyi's flow theory from the perspective of people living with head and neck cancer. Interviews were conducted with seven participants diagnosed with and treated for different forms and stages of head and neck cancer. Results: Experiences of flow were associated with people's interests, skill levels and actions involving and creating both happiness and the feeling of something worth living for. Optimal flow was a state of consciousness in which mind and body work together, and the people were completely absorbed in an activity related to nature, hobbies or family. Microflow occurred as part of everyday life, relieving stress and anxiety and helping them to focus on their daily routines. This included humming, listening to the radio or watching TV. Conclusions: The peoples inner strength and desire to feel better made flow possible, and they used unknown skills that enhanced self-satisfaction. Managing self-care activities increased feelings of control, participation and enjoyment. This calls for person-centred care with a salutogenic approach based on the peoples own interests, skill levels and actions; what makes the person feel happy.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Empowerment, Flow theory, Happiness, Head and neck cancer, Life experiences, Person-centred care, Qualitative content analysis, Salutogenic approach
National Category
Cancer and Oncology Psychology Other Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-91027 (URN)10.1016/j.ejon.2019.09.012 (DOI)000505109300009 ()31622871 (PubMedID)
Available from: 2020-01-20 Created: 2020-01-20 Last updated: 2020-01-20Bibliographically approved
Instenes, I., Fridlund, B., Amofah, H. A., Ranhoff, A. H., Eide, L. S. P. & Norekval, T. M. (2019). 'I hope you get normal again': an explorative study on how delirious octogenarian patients experience their interactions with healthcare professionals and relatives after aortic valve therapy. European Journal of Cardiovascular Nursing, 18(3), 224-233
Open this publication in new window or tab >>'I hope you get normal again': an explorative study on how delirious octogenarian patients experience their interactions with healthcare professionals and relatives after aortic valve therapy
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2019 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 3, p. 224-233Article in journal (Refereed) Published
Abstract [en]

Background: Delirium affects nearly half of octogenarian patients after aortic valve replacement, resulting in impaired cognition, reduced awareness and hallucinations. Although healthcare professionals and relatives are often present during episodes, the nature of interactions with them is scarcely studied, and little is known about their long-term experiences. Purpose: The purpose of this study was to explore and describe how octogenarian patients with post-aortic valve replacement delirium experience interactions with healthcare professionals and relatives within the first year and four years later. Method: An explorative design with qualitative content analysis was used. Delirium was assessed for five consecutive days after aortic valve replacement using the Confusion Assessment Method. Delirious patients (n=10) were interviewed 6-12 months post-discharge and four years later (n=5). We used an inductive approach to identify themes in transcribed interviews. Findings: An overarching theme emerged: 'Healthcare professionals' and relatives' responses made a considerable impact on the delirium experience postoperatively and in a long-term'. Three sub-themes described the patients' experiences: 'the need for close supportive care', 'disrespectful behaviour created a barrier' and 'insensitive comments made lasting impressions'. Having healthcare professionals and relatives nearby made the patients feel secure, while lack of attention elevated patients' emotional distress. Four years later, patients clearly recalled negative comments and unsupportive actions in their delirious state. Conclusions: Healthcare professionals and relatives have an essential role in the aortic valve replacement recovery process. Inconsiderate behaviour directed at older patients in delirium elevates distress and has long-term implications. Supportive care focused on maintaining the patients' dignity and integrity is vital.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Delirium, octogenarian patients, qualitative research, surgical aortic valve replacement, transcatheter aortic valve replacement
National Category
Nursing Cardiac and Cardiovascular Systems
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-81084 (URN)10.1177/1474515118810622 (DOI)000459871100007 ()30379104 (PubMedID)2-s2.0-85059273097 (Scopus ID)
Available from: 2019-03-15 Created: 2019-03-15 Last updated: 2019-11-08Bibliographically approved
Nord-Ljungquist, H., Engström, Å., Fridlund, B. & Elmqvist, C. (2019). Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment. Scandinavian Journal of Caring Sciences
Open this publication in new window or tab >>Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment
2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background In a rural environment where distances and access to ambulance resources in people's immediate area are limited, other responders like firefighters dispatched to perform a first aid before ambulance arrives in areas where a longer response time exists; an assignment called 'While Waiting for the Ambulance' (WWFA). Knowledge is limited about the experience from a caller's perspective when a person has a life-threatening condition needing emergency help and both firefighters in a WWFA assignment and ambulance staff are involved. Aim The aim of the study is to describe the emergency situation involving a WWFA assignment in a rural environment from the caller's perspective. Method A descriptive design using qualitative methodology with a reflective lifeworld research (RLR) approach was used for this study, including in-depth interviews with eight callers. Results An emergency situation involving WWFA assignment in a rural environment mean a sense of being lone and lonely with a vulnerability in while waiting to hand over responsibility for the affected person. Ambivalence in several dimensions arises with simultaneous and conflicting emotions. A tension between powerlessness and power of action where the throw between doubt and hope are abrupt with a simultaneous pendulum between being in a chaos and in a calm. Conclusion A double ambivalence emerges between, on one hand feeling alone in the situation and having full control, on the other hand, with trust handing over the responsibility, thereby losing control. Contact with the emergency medical dispatcher becomes a saving lifeline to hold onto, and access to emergency help in the immediate area of WWFA is valuable and important. Trust and confidence are experienced when callers are met with empathy, regardless of personal acquaintance with arriving responders.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
ambulance staff, caller, CPR, emergency medical dispatcher, emergency situation, firefighters, first aid, reflective lifeworld research, responder, rural environment
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-89970 (URN)10.1111/scs.12767 (DOI)000492266600001 ()31614024 (PubMedID)
Available from: 2019-11-08 Created: 2019-11-08 Last updated: 2019-11-08
Brors, G., Pettersen, T. R., Hansen, T. B., Fridlund, B., Holvold, L. B., Lund, H. & Norekval, T. M. (2019). Modes of e-Health delivery in secondary prevention programmes for patients with coronary artery disease: a systematic review. BMC Health Services Research, 19, 1-24, Article ID 364.
Open this publication in new window or tab >>Modes of e-Health delivery in secondary prevention programmes for patients with coronary artery disease: a systematic review
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2019 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, p. 1-24, article id 364Article, review/survey (Refereed) Published
Abstract [en]

BackgroundElectronic health (e-Health) interventions are emerging as an effective alternative model for improving secondary prevention of coronary artery disease (CAD). The aim of this study was to describe the effectiveness of different modes of delivery and components in e-Health secondary prevention programmes on adherence to treatment, modifiable CAD risk factors and psychosocial outcomes for patients with CAD.MethodA systematic review was carried out based on articles found in MEDLINE, CINAHL, and Embase. Studies evaluating secondary prevention e-Health programmes provided through mobile-Health (m-Health), web-based technology or a combination of m-Health and web-based technology were eligible. The main outcomes measured were adherence to treatment, modifiable CAD risk factors and psychosocial outcomes. The quality appraisal of the studies included was conducted using the Joanna Briggs Institute critical appraisal tool for RCT. The results were synthesised narratively.ResultA total of 4834 titles were identified and 1350 were screened for eligibility. After reviewing 123 articles in full, 24 RCTs including 3654 participants with CAD were included. Eight studies delivered secondary prevention programmes through m-Health, nine through web-based technology, and seven studies used a combination of m-Health and web-based technology. The majority of studies employed two or three secondary prevention components, of which health education was employed in 21 studies. The m-Health programmes reported positive effects on adherence to medication. Most studies evaluating web-based technology programmes alone or in combination with m-Health also utilised traditional CR, and reported improved modifiable CAD risk factors. The quality appraisal showed a moderate methodological quality of the studies.ConclusionEvidence exists that supports the use of e-Health interventions for improving secondary prevention of CAD. However, a comparison across studies highlighted a wide variability of components and outcomes within the different modes of delivery. High quality trials are needed to define the most efficient mode of delivery and components capable of addressing a favourable outcome for patients.Trial registrationNot applicable.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Coronary artery disease, E-health, M-health, Secondary prevention programme, Systematic review
National Category
Other Health Sciences
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-86857 (URN)10.1186/s12913-019-4106-1 (DOI)000470991100004 ()31182100 (PubMedID)2-s2.0-85067126409 (Scopus ID)
Available from: 2019-07-16 Created: 2019-07-16 Last updated: 2019-11-08Bibliographically approved
Broström, A., Pakpour, A. H., Nilsen, P., Fridlund, B. & Ulander, M. (2019). Psychometric properties of the Ethos Brief Index (EBI) using factorial structure and Rasch Analysis among patients with obstructive sleep apnea before and after CPAP treatment is initiated. Sleep and Breathing, 23(3), 761-768
Open this publication in new window or tab >>Psychometric properties of the Ethos Brief Index (EBI) using factorial structure and Rasch Analysis among patients with obstructive sleep apnea before and after CPAP treatment is initiated
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2019 (English)In: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 23, no 3, p. 761-768Article in journal (Refereed) Published
Abstract [en]

Background Continuous positive airway treatment (CPAP) is the recommended treatment for patients with obstructive sleep apnea (OSA). Outcome measures often focus on clinical and/or self-rated variables related to the medical condition. However, a brief validated instrument focusing on the whole life situation (i.e., ethos) suitable for clinical practice is missing. The aim of this study was to investigate factorial structure, categorical functioning of the response scale, and differential item functioning across sub-populations of the Ethos Brief Index (EBI) among patients with obstructive sleep apnea (OSA) before and after initiation of continuous positive airway pressure (CPAP). Methods A prospective design, including 193 patients with OSA (68% men, 59.66 years, SD 11.51) from two CPAP clinics, was used. Clinical assessment and overnight respiratory polygraphy were used to diagnose patients. Questionnaires administered before and after 6 months of CPAP treatment included EBI, Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, and global perceived health (initial item in SF-36). The validity and reliability of the EBI were investigated using Rasch and confirmatory factor analysis models. Measurement invariance, unidimensionality, and differential item functioning across gender groups, Apnea-Hypopnea Index, and ESS groups were assessed. Results The reliability of the EBI was confirmed using composite reliability and Cronbach's alpha. The results supported unidimensionality of the EBI in confirmatory factor analysis and the Rasch model. No differential item functioning was found. A latent profile analysis yielded two profiles of patients with low (n = 42) and high (n = 151) ethos. Patients in the low ethos group were younger and had higher depression scores, lower perceived health, and higher body mass index. Conclusions The EBI is a valid tool with robust psychometric properties suitable for use among patients with OSA before and after treatment with CPAP is initiated. Future studies should focus on its predictive validity.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Obstructive sleep apnea, Continuous positive airway treatment, Ethos, Validity, Reliability
National Category
Other Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-89258 (URN)10.1007/s11325-018-1762-z (DOI)000482433800006 ()30523558 (PubMedID)
Available from: 2019-09-25 Created: 2019-09-25 Last updated: 2019-11-08Bibliographically approved
Elmqvist, C., Svensson, A., Engdahl, S., Forsgärde, E.-S., Fridlund, B., Kurland, L., . . . Lundberg, U. (2019). ”Vi vill ha en statlig nationell översikt över mobil vård”. Dagens medicin (2019-09-26)
Open this publication in new window or tab >>”Vi vill ha en statlig nationell översikt över mobil vård”
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2019 (Swedish)In: Dagens medicin, ISSN 1104-7488, no 2019-09-26Article in journal, News item (Other (popular science, discussion, etc.)) Published
Abstract [sv]

Den mobila vården behöver definieras nationellt och bli en egen organisationsform och vårdnivå, skriver företrädare från Centrum för interprofessionell samverkan inom akut vård.

Place, publisher, year, edition, pages
Bonnier Business Media AB, 2019
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-89902 (URN)
Available from: 2019-11-04 Created: 2019-11-04 Last updated: 2019-12-18Bibliographically approved
Pettersen, T. R., Fridlund, B., Bendz, B., Nordrehaug, J. E., Rotevatn, S., Schjott, J. & Norekval, T. M. (2018). Challenges adhering to a medication regimen following first-time percutaneous coronary intervention: A patient perspective. International Journal of Nursing Studies, 88, 16-24
Open this publication in new window or tab >>Challenges adhering to a medication regimen following first-time percutaneous coronary intervention: A patient perspective
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2018 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 88, p. 16-24Article in journal (Refereed) Published
Abstract [en]

Background: Percutaneous coronary intervention is the most common therapeutic intervention for patients with narrowed coronary arteries due to coronary artery disease. Although it is known that patients with coronary artery disease often do not adhere to their medication regimen, little is known about what patients undergoing percutaneous coronary interventions find challenging in adhering to their medication regimen after hospital discharge. Objectives: To explore patients' experiences in adhering to medications following early post-discharge after first-time percutaneous coronary intervention. Design: An abductive qualitative approach was used to conduct in-depth interviews of patients undergoing first-time percutaneous coronary intervention. Settings: Participants were recruited from a single tertiary university hospital, which services a large geographical area in western Norway. Patients fulfilling the inclusion criteria were identified through the Norwegian Registry for Invasive Cardiology. Participants: Participants were patients aged 18 years or older who had their first percutaneous coronary intervention six to nine months earlier, were living at home at the time of study inclusion, and were prescribed dual antiplatelet therapy. Patients who were cognitively impaired, had previously undergone cardiac surgery, and/or were prescribed anticoagulation therapy with warfarin or novel oral anticoagulants were excluded. Purposeful sampling was used to include patients of different gender, age, and geographic settings. Twenty-two patients (12 men) were interviewed between December 2016 and April 2017. Methods: Face-to-face semi-structured interviews were conducted, guided by a set of predetermined open-ended questions to gather patient experiences on factors relating to medication adherence or non-adherence. Transcribed interviews were analysed by qualitative content analysis. Findings: Patients failed to adhere to their medication regimen for several reasons; intentional and unintentional reasons, multifaceted side effects from heart medications, scepticism towards generic drugs, lack of information regarding seriousness of disease after percutaneous coronary intervention, psychological impact of living with coronary artery disease, and these interacted. There were patients who felt that the medication information they received from physicians and nurses was uninformative and inadequate. Side effects from heart medications were common, ranging from minor ones to more disabling side effects, such as severe muscle and joint pain and fatigue. Patients found well established medication taking routines and aids to be necessary, and these improved adherence. Conclusion: Patients undergoing first-time percutaneous coronary intervention face multiple, interacting challenges in trying to adhere to prescribed medications following discharge. This study highlights the need for a more structured follow-up care in order to improve medication adherence and to maximise their self-care abilities.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Coronary artery disease, Percutaneous coronary intervention, Qualitative research, Medication adherence, Patient-centered care
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-79746 (URN)10.1016/j.ijnurstu.2018.07.013 (DOI)000454965600003 ()30165236 (PubMedID)2-s2.0-85052301594 (Scopus ID)
Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2019-11-08Bibliographically approved
Pettersen, T., Schjott, J., Bendz, B., Fridlund, B., Nordrehaug, J. E., Rotevatn, S. & Norekvaal, T. M. (2018). Discontinuation of drug treatment due to side effects after first-time percutaneous coronary intervention: a patient perspective.. European Journal of Cardiovascular Nursing, 17, 58-59
Open this publication in new window or tab >>Discontinuation of drug treatment due to side effects after first-time percutaneous coronary intervention: a patient perspective.
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, p. 58-59Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sage Publications, 2018
National Category
Cardiac and Cardiovascular Systems Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-77382 (URN)000440339600100 ()
Available from: 2018-08-30 Created: 2018-08-30 Last updated: 2019-11-08Bibliographically approved
Svensson, A., Almerud Österberg, S., Fridlund, B., Stening, K. & Elmqvist, C. (2018). Firefighters as First Incident Persons: breaking the chain of events and becoming a new link in the chain of survival. International Journal of Emergency Services, 7(2), 120-133
Open this publication in new window or tab >>Firefighters as First Incident Persons: breaking the chain of events and becoming a new link in the chain of survival
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2018 (English)In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 7, no 2, p. 120-133Article in journal (Refereed) Published
Abstract [en]

Purpose In order to shorten the response time, two part-time fire departments (FDs) in Sweden initialize a first incident person (FIP) assignment. This is done by alarming the crew manager as an FIP, responding in a separate emergency vehicle, and by arriving at the scene before rest of the crew. The purpose of this paper is to explore and describe experiences of the FIP assignment within an FD. Design/methodology/approach A multimethod design was used, influenced by Creswell and Plano Clark's (2011) explanatory sequential mixed method design including emergency reports, a questionnaire and interviews. Findings The results show that the FIP assignment was a function that secured an early presence at the scene of an accident or emergency situations, which is beneficial for society in the form of a safety factor, for the firefighters in the form of early prior information on what to expect at the scene and for the patient in the form of early existential support and increased chances of survival. Originality/value In order to prevent full scenarios to happen and get the chance to save lives, an early response must be ensured. Hence, studies must be made in different settings, based on its unique conditions. This study indicates that by implementing FIP in FDs placed in a rural area, the FIP can break the chain of events and becoming a new link in the chain of survival.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Other Medical Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-69815 (URN)10.1108/IJES-10-2017-0051 (DOI)000432829500004 ()2-s2.0-85040866305 (Scopus ID)
Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2019-08-29Bibliographically approved
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